| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| J0178 |
Injection, aflibercept, 1 mg |
2,108 |
1,815 |
$2.10M |
| 92014 |
Ophthalmological services: medical examination and evaluation, comprehensive, established patient |
16,724 |
14,500 |
$1.01M |
| 92004 |
Ophthalmological services: medical examination and evaluation, comprehensive, new patient |
10,555 |
9,922 |
$731K |
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
5,000 |
4,367 |
$229K |
| 67028 |
Intravitreal injection of a pharmacologic agent |
4,152 |
3,463 |
$196K |
| 92060 |
|
3,616 |
3,393 |
$179K |
| 92015 |
Determination of refractive state |
23,985 |
22,250 |
$179K |
| 92134 |
|
9,816 |
8,050 |
$158K |
| 99204 |
Office or other outpatient visit for the evaluation and management of a new patient, moderate complexity |
1,396 |
1,240 |
$129K |
| 92012 |
Ophthalmological services: medical examination and evaluation, intermediate, established patient |
1,955 |
1,769 |
$113K |
| V2100 |
Sphere, single vision, plano to plus or minus 4.00, per lens |
4,438 |
4,384 |
$108K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
1,879 |
1,588 |
$97K |
| V2020 |
Frames, purchases |
3,209 |
3,170 |
$64K |
| 99203 |
Office or other outpatient visit for the evaluation and management of a new patient, low complexity |
460 |
422 |
$33K |
| J2777 |
Injection, faricimab-svoa, 0.1 mg |
27 |
25 |
$28K |
| V2784 |
Lens, polycarbonate or equal, any index, per lens |
4,606 |
4,546 |
$27K |
| 92133 |
|
1,218 |
1,115 |
$25K |
| S0620 |
Routine ophthalmological examination including refraction; new patient |
319 |
319 |
$14K |
| 92002 |
|
198 |
198 |
$9K |
| V2025 |
Deluxe frame |
228 |
224 |
$8K |
| 99212 |
Office or other outpatient visit for the evaluation and management of an established patient, straightforward |
248 |
227 |
$8K |
| 92250 |
|
330 |
309 |
$6K |
| S0621 |
Routine ophthalmological examination including refraction; established patient |
95 |
95 |
$4K |
| 92083 |
|
151 |
128 |
$4K |
| 99202 |
Office or other outpatient visit for the evaluation and management of a new patient, straightforward |
58 |
55 |
$3K |
| V2750 |
Anti-reflective coating, per lens |
28 |
28 |
$400.05 |
| 92025 |
|
14 |
13 |
$348.70 |
| 92020 |
|
17 |
12 |
$214.92 |
| 99058 |
|
12 |
12 |
$61.14 |
| G2211 |
Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition. (add-on code, list separately in addition to office/outpatient evaluation and management visit, new or established) |
15 |
14 |
$19.55 |
| V2755 |
U-v lens, per lens |
12 |
12 |
$0.00 |